Smoking Update Saturday 16 June 2007

The following was posted by me as a comment on my original blog entitled "Smoking", but I know a lot of people didn't see it...

I went with my mother to see the specialist consultant at Amersham hospital yesterday (15th June). The appointment was with Mr Andrew Northeast, but in fact we saw one of his registrars.

To cut to the chase the doctor said that my mother has a mild circulatory problem. The arteries in the leg are clear down to the point at which it divides into 3 sub arteries in the ankle where there is some sign of hardening of the arteries and/or blockage. The veins are similarly in good condition and the valves in the thigh and the knee which often fail are working, however the valves in the calves have failed and are leaking. This combined with her immobility has caused the pooling of blood and other fluid below the knee and the ulcers. He suggested that my mother has "mild heart failure" which is causing fluid to build up in her lungs.

Generally my mother is in good shape. So much so, when looking at the results of the artery tests the doctor said "You have never smoked, have you?" I almost fell off my chair - and if you don't believe me, I have a recording of the whole consultation, that when I manage to get it off my mobile phone I will send to you.

He recommended the following:

1. A chest X-ray to see the condition of her heart and lungs and to see if there is a fluid build-up. We had that done immediately afterwards and the results will be sent to her GP next week
2. An appointment to see her GP next week to discuss the breathlessness and the X-ray. He suggested that the GP may prescribe diuretics.
3. Compression stockings - we were sent immediately to get my mother measured up for them, but unfortunately the woman who does this is on leave. my mother has an appointment for 2:30 on 6th July for this.
4. More exercise
5. Keeping her feet up in the recliner and in bed
6. A six monthly check-up with her GP. He was stunned that my mother has never had a chest X-ray and does not know her blood pressure status.
   

After the appointment I discussed all these points with my mother. She said she had taken diuretics once, and implied that as a result she didn't need to take them again! She also said on multiple occasions while with the doctor and with me before and afterwards that her GP has 'more important things to do than see her'. She said believes that she shouldn't bother the doctor and anyway she didn't want to 'hear the bad news' so she would only go to the doctors when she had a list of things wrong. The doctor and I tried to impress upon my mother that the emphasis was now on prevention rather than cure.

So all in all, much to everyone's surprise, my mother is in good shape. She has had a nasty shock with the sudden flare up of what appears to be just a combination of acute Cellulitis combined with her chronic problems of the leg ulcers and poor circulation. The circulation problems themselves are mild and can be effectively treated by compression stockings, leg elevation and exercise. Of course exercise itself is an issue because of her breathlessness. If we can get to the root cause of this and discover whether it is emphysema, heart failure, or just smoking then perhaps she will outlive us all!

I am not sure how much of this has yet sunk in with my mother and I certainly don't want her to think she can take up smoking again as she hasn't got the dreaded "smoker's leg". The consultation itself was I think a bit confusing for her. First of all the consulting room was a little echoey and secondly the doctor was african and had a fairly strong accent that she didn't understand.

So she is OK, she hasn't got Peripheral Arterial Disease, and is not in risk of having her legs amputated. I won't apologise for shouting "Wolf" - the last few weeks has given us all a wake-up call. It has finally got my mother off the evil weed and she is delighted to be off it and I think it has also made us all realise that we weren't doing enough for her. Please please keep up the contacts you have made with the old lady. She does really enjoy the attention she is getting and it is really helping her.

If you haven't contacted her recently, then please either phone her, or alternatively write to her. Writing may sound odd, because of her eyesight being so poor, but she loves to receive letters - write big, or alternately type it into Word and use a large font. I know my brother does this and she can read what he writes... Try it with 18 point font this should be legible. Also please encourage other relatives and friends to contact her by phone or letter.